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Adv Nutr. 2016 Jan 15;7(1):112-20. doi: 10.3945/an.115.009951. Print 2016 Jan.

A Review of Cutoffs for Nutritional Biomarkers.

Author information

Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD;
Department of Nutrition and Food Science, University of Maryland, College Park, MD; and.
Office of Dietary Supplements, NIH, Bethesda, MD.


The nutritional status of an individual or population needs to be assessed through valid and reliable biomarkers. Cutoffs generally have an underlying relation to health status and are one of the important quantitative criteria against which biomarker outputs are compared. For this reason, cutoffs are integral for surveys, surveillance, screening, interventions, monitoring, and evaluation. Despite their importance, nutritional biomarker cutoffs have not been adequately addressed in the literature. Furthermore, the field has not reached a consensus on which cutoff to use for each biomarker, and different cutoffs are often used for the same biomarkers in published studies. This review provides a comprehensive overview of cutoffs related to nutritional biomarkers and highlights some of the high-priority research gaps and challenges of using micronutrient case studies.


ROC curve; Youden index; cutoffs; nutritional assessment; nutritional biomarkers; nutritional deficiency; nutritional surveillance; reference values

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